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Individual

JORDAN DESTINY BRADDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC MHSP, LPCC

Contact information

Practice address
117 HUXLEY RD STE B-3, KNOXVILLE, TN 37922-3179
(865) 237-6979
Mailing address
117 HUXLEY RD STE B-3, KNOXVILLE, TN 37922-3179
(865) 237-6979

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
295819
KY
101YM0800X
Mental Health Counselor
Primary
4450
TN
101YP2500X
Professional Counselor
4450
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
295819
LICENSE
KY
01
4450
LICENSE
TN
Enumeration date
07/12/2019
Last updated
03/13/2025
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